EFFECT OF EVJENTH-HAMBERG TECHNIQUE ON CERVICAL PAIN AND RANGE OF MOTION IN EPISODIC TENSION-TYPE HEADACHE AMONGST COLLEGE STUDENTS: A RANDOMIZED CONTROLLED TRIAL

Objective: To compare the effect of the Evjenth-Hamberg technique (EHS) along with conventional transcutaneous electrical nerve stimulation (TENS) and cervical isometric exercises with TENS on neck pain and active range of motion (ROM) in college students with episodic tension-type headache (ETTH). Methods: An interventional trial was performed on 30 college students with ETTH who were randomly allocated into two equal groups (n=15). The intervention consisted of EHS along with conventional-mode TENS for group A and cervical isometric exercises with TENS for group B. Both groups received three treatment sessions per week for 4 weeks. The numerical pain rating scale (NPRS) and the universal goniometer were used to assess the pain intensity and active cervical ROM, respectively. For statistical analysis, paired t-test was used for within-group comparisons whereas baseline-adjusted analysis of covariance and Hedges’ g were used for assessing the between-group differences. Results: Both groups showed significant improvements in NPRS and all six cervical ROM measures (p<0.001). NPRS improved by 2.80±0.68 in Group A and 2.07±0.59 in Group B. Cervical flexion improved by 10.80±1.26° and 7.60±1.55°, respectively. Group A showed significantly greater improvement in NPRS (adjusted difference B-A=0.61, 95% CI 0.21–1.02; p=0.005) and all six cervical ROM measures (p<0.001). Conclusion: EHS combined with TENS show greater improvements in cervical pain and active ROM than cervical isometric exercises combined with TENS in college students with ETTH. Keywords: episodic tension-type headache; Evjenth-Hamberg technique; cervical range of motion; neck pain; manual therapy; transcutaneous electrical nerve stimulation